Meth use is driving overdose epidemic in rural America, not opioids

PORTLAND – Hit shows like “Breaking Bad” highlighted the dangerous nature of making and using methamphetamine. Now, a new study finds that the drug common in popular culture is also a common problem in rural America. Researchers at Oregon Health & Science University say meth use is driving the nation’s overdose crisis, rather than the commonly suspected cause: opioids.

In a study of more than 3,000 people living in rural communities, the team found that about four out of five people who use drugs used methamphetamines in the past month.

“Among people who use drugs in rural communities, methamphetamine use is widespread,” says Todd Korthuis, MD, MPH, professor of medicine at the OHSU School of Medicine, in a university statement. “This has been a problem on the West Coast for a long time, but now we’re seeing methamphetamine use in rural communities across the United States.”

The team focused on residents of 10 states between January 2018 and March 2020. These people lived in rural areas with the highest overdose rates in Oregon, Illinois, Kentucky, North Carolina, Ohio, Wisconsin, West Virginia, Massachusetts, New Hampshire and Vermont. .

What is the difference between methamphetamine and opioids?

Methamphetamine, commonly known as methamphetamine or crystal meth, is a stimulant that induces a “high” that can sometimes last for more than 12 hours. Opioids, such as heroin, fentanyl, or prescription pain relievers, are depressants that slow the activity of the central nervous system, including breathing. An opioid high is usually shorter than a meth high.

Much of the country’s attention has focused on opioids, which account for the majority of more than 100,000 overdose deaths in the US last year, according to researchers. Most of these deaths were the result of taking fentanyl, a synthetic opioid 50 to 100 times stronger than morphine.

However, Korthuis says this is causing many to overlook the problem of widespread methamphetamine use outside of urban cities. In addition, the study authors note that fentanyl is now frequently contaminating batches of methamphetamine. While people may think they’re just taking a stimulant, they’re actually getting a potentially fatal dose of opioids.

Results from the Rural Opioid Initiative study show that people who took both methamphetamine and opioids had the highest risk of a nonfatal overdose. More than one in five (22%) who took both substances reported having overdosed in the previous six months.

Among rural Americans who say they only use opioids, 14 percent experienced a recent overdose. Meanwhile, only six percent of meth-only users suffered a non-fatal overdose.

“The combined use of methamphetamine and opioids is associated with a greatly increased risk of overdose in rural communities,” says Korthuis. “Some people see rural areas as immune to problems like drug use and overdose, but they’re not.”

Economic hardship in rural America leads to more ‘deaths of despair’

The study also found that economic hardship is a widespread problem among these drug-dominated communities. In fact, 53 percent reported being homeless at some point in the previous six months. Researchers say these problems among low-income communities increase the number of “deaths of despair,” those involving overdoses, suicides, and drug- and alcohol-related illnesses.

“There are deaths of despair everywhere, but our rural communities have been hit hard,” explains Korthuis.

The study’s authors add that treatment problems are less likely to reach Americans who live in these communities. Four in 10 respondents said they tried to get substance abuse treatment but couldn’t find help in their area. Among those using meth and opioids, 44 percent were unable to access treatment.

The team also cautions that people who take meth are rarely given naloxone, an overdose treatment that often revives people who take fentanyl. They are urging health officials to expand the distribution of this overdose drug so that people who take methamphetamine also have it.

The study is published in JAMA Open Network.

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